Provider Demographics
NPI:1437108115
Name:UGORJI, CHINENYE ANNA (RDH AND LCSW)
Entity type:Individual
Prefix:
First Name:CHINENYE
Middle Name:ANNA
Last Name:UGORJI
Suffix:
Gender:F
Credentials:RDH AND LCSW
Other - Prefix:MS
Other - First Name:CHINENYE
Other - Middle Name:ANNA
Other - Last Name:UGORJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH AND LCSW
Mailing Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Mailing Address - Street 2:
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5638
Mailing Address - Country:US
Mailing Address - Phone:210-292-6255
Mailing Address - Fax:210-292-7934
Practice Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:210-292-6255
Practice Address - Fax:210-292-7934
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402206142124Q00000X
TX18633124Q00000X
TX1046271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1180709661OtherDOD